Prevalência e fatores associados à infecção em pacientes com diabetes mellitus que sofreram amputação

Priscila de Oliveira Soares Rocha; Jefferson Abraão Caetano Lira; Hellen Gomes Evangelista; Guilherme Gonçalves Bezerra de Jesus; Aline Costa de Oliveira; josiane Santos Silva; Sandra Marina Gonçalves Bezerra

Authors

Priscila de Oliveira Soares Rocha Universidade Estadual do Piauí – Teresina (PI), Brasil. https://orcid.org/0000-0002-7985-0184
Jefferson Abraão Caetano Lira Universidade Federal do Piauí – Teresina (PI), Brasil. ,https://ror.org/00kwnx126 https://orcid.org/0000-0002-7582-4157
Hellen Gomes Evangelista Universidade Estadual do Piauí – Teresina (PI), Brasil. ,https://ror.org/02na6tz09 https://orcid.org/0000-0001-9644-1983
Guilherme Gonçalves Bezerra de Jesus Universidade Federal do Piauí – Teresina (PI), Brasil. ,https://ror.org/00kwnx126 https://orcid.org/0000-0003-38
Aline Costa de Oliveira Universidade Estadual do Piauí – Teresina (PI), Brasil. ,https://ror.org/02na6tz09 https://orcid.org/0000-0003-1738-4808
josiane Santos Silva Universidade Estadual do Piauí – Teresina (PI), Brasil. https://orcid.org/0000-0003-4535-0736
Sandra Marina Gonçalves Bezerra Universidade Estadual do Piauí – Teresina (PI), Brasil. ,https://ror.org/02na6tz09 https://orcid.org/0000-0003-3890-5887

Abstract

Objective: To analyze the prevalence and factors associated with infection in patients with diabetes mellitus who underwent lower extremity amputation. Method: Cross-sectional, retrospective, and analytical study carried out in a high complexity hospital in Teresina, Piauí, with 70 medical records of patients admitted from January 2015 to December 2016. Inferential analysis was performed using χ² association tests. Pearson and Fisher’s exact, considering p<0.05 to be significant. Results: Of the 70 participants, 81.4% were over 60 years old, 57.1% were married, 41.4% had low education, 82.8% had an income of 1 to 2 minimum wages, and 52.9% were coming from the interior of Piauí. The average length of stay was 25 days. The leg was the most prevalent site of amputation (38.6%). The prevalence of infection was 74.4% and only 7.1% of patients underwent culture. Family income (p=0.032) and length of stay (p=0.014) were significantly associated with infection. Conclusion: The prevalence of infection in patients with diabetes mellitus who underwent lower extremity amputation was high, being associated with family income and length of stay, highlighting the importance of understanding these factors for implementing preventive measures.

Downloads

Download data is not yet available.

Author Biographies

Priscila de Oliveira Soares Rocha, Universidade Estadual do Piauí – Teresina (PI), Brasil.

Enfermeira pós graduada em Estomaterapia da Universidade Estadual do Piauí. Coordenadora do Ambulatório de Estomaterapia da Prefeitura Municipal de Guadalupe

Jefferson Abraão Caetano Lira, Universidade Federal do Piauí – Teresina (PI), Brasil. ,https://ror.org/00kwnx126

Doutor em enfermagem pela Universidade Federal do Piauí. Professor colaborador da Universidade Estadual do Piauí

Hellen Gomes Evangelista, Universidade Estadual do Piauí – Teresina (PI), Brasil. ,https://ror.org/02na6tz09

Enfermeira pela Universidade Estadual do Piauí

Guilherme Gonçalves Bezerra de Jesus, Universidade Federal do Piauí – Teresina (PI), Brasil. ,https://ror.org/00kwnx126

Médico, residente da clínica m´´edica do Hospital Universitário da UFPI

Aline Costa de Oliveira, Universidade Estadual do Piauí – Teresina (PI), Brasil. ,https://ror.org/02na6tz09

Enfermeira Estomaterapeuta pela Universidade Estadual do Piauí. Doutoranda do PPGENF-UFPI

josiane Santos Silva, Universidade Estadual do Piauí – Teresina (PI), Brasil.

Enfermeira Estomaterapeuta Pela UESPI. Mestranda do PPGEnf- UFPI

Sandra Marina Gonçalves Bezerra, Universidade Estadual do Piauí – Teresina (PI), Brasil. ,https://ror.org/02na6tz09

Doutora em enfermagem e Estomaterapeuta - TiSobest

Professora Adjunta da Universidade Estadual do Piauí

Coordenadora da Especialização em Estomaterapia - UESPI

Coordenadora operacional do DINTER UFPI/UESPI

References

Hinkle J, Cheever K. Brunner & Suddarth: tratado de enfermagem médico-cirúrgica. 14a ed. Rio de Janeiro: Guanabara Koogan; 2020.

International Diabetes Federation. IDF diabetes atlas [Internet]. 10a ed. Belgium: IDF; 2021 [acessado 10 dez. 2023]. Disponível em: https://www.diabetesatlas.org

Goyal R, Singhal M, Jialal I. Type 2 diabetes. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.

Polk C, Sampson MM, Roshdy D, Davidson LE. Skin and soft tissue infections in patients with diabetes mellitus. Infect Dis Clin North Am. 2021;35(1):183-97. https://doi.org/10.1016/j.idc.2020.10.007

Falcone M, Meier JJ, Marini MG, Caccialanza R, Aguado JM, Del Prato S, Menichetti F. Diabetes and acute bacterial skin and skin structure infections. Diabetes Res Clin Pract. 2021 Apr;174:108732. https://doi.org/10.1016/j.diabres.2021.108732

Hicks C, Selvin E. Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Curr Diab Rep. 2019 Aug; 19(10):86. https://doi.org/10.1007/s11892-019-1212-8

Brasil. Conselho Nacional de Saúde. Resolução no 466, de 12 de dezembro de 2012. Aprova as seguintes diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Brasília: Diário Oficial da União; 2012.

Barbosa Marques AD, Sales da Silva LM, Magalhães Moreira TM, Martins Torres RA. Asociación entre hospitalización por diabetes mellitus y amputación de pie diabéticos. Enferm Glob. 2018 Jul;17(51):238-66. https://doi.org/10.6018/eglobal.17.3.286181

Abu-Ashour W, Twells LK, Valcour JE, Gamble JM. Diabetes and the occurrence of infection in primary care: a matched cohort study. BMC Infect Dis. 2018 Feb;18(1):67. https://doi.org/10.1186/s12879-018-2975-2

Lavery LA, Oz OK, Bhavan K, Wukich DK. Diabetic foot syndrome in the twenty-first century. Clin Podiatr Med Surg. 2019 Jul;36(3):355-9. https://doi.org/10.1016/j.cpm.2019.02.002

Baumfeld D, Baumfeld T, Macedo B, Zambelli R, Lopes F, Nery C. Factors related to amputation level and wound healing in diabetic patients. Acta Ortop Bras. 2018;26(5):342-5. https://doi.org/10.1590/1413-785220182605173445

Cardoso NA, Cisneros LL, Machado CJ, Procópio RJ, Navarro TP. Risk factors for mortality among patients undergoing major amputations due to infected diabetic feet. J Vasc Bras. 2018 Oct-Dec;17(4):296-302. https://doi.org/10.1590/1677-5449.010717

Nicoletti GP, Nascimento NKL, Gurgel JAR, Brandão GHA. Perfil de pacientes diabéticos, um estudo emu ma farmácia Natal/RN. Braz J Dev. 2020;6(11):84730-46. https://doi.org/10.34117/bjdv6n11-040

Souza CL, Oliveira MV. Fatores associados ao descontrole glicêmico de diabetes mellitus em pacientes atendidos no Sistema Único de Saúde no Sudoeste da Bahia. Cad Saúde Colet. 2020;28(1):153-64. https://doi.org/10.1590/1414-462X202028010319

Tehan PE, Hawes MB, Hurst J, Sebastian M, Peterson BJ, Chuter VH. Factors influencing lower extremity amputation outcomes in people with active foot ulceration in regional Australia: a retrospective cohort study. Wound Repair Regen. 2022 Jan;30(1):24-33. https://doi.org/10.1111/wrr.12978

Jesus-Silva SG, Oliveira JP, Brianezi MHC, Silva MAM, Krupa AE, Cardoso RS. Análise dos fatores de risco relacionados às amputações maiores e menores de membros inferiores em hospital terciário. J Vasc Bras. 2017;16(1):16-22. https://doi.org/10.1590/1677-5449.008916

Choi Y. Rehabilitation of patients after diabetic foot amputation. J Korean Med Assoc. 2021;64(8):537-42. https://doi.org/10.5124/jkma.2021.64.8.537

International Working Group on the Diabetic Foot. IWGDF guidelines on the prevention and management of diabetes-related foot disease [Internet]. [acessado 04 fev. 2024]. Disponível em: https://iwgdfguidelines.org/wp-content/uploads/2023/07/IWGDF-Guidelines-2023.pdf

Lira JAC, Nogueira LT, Oliveira BMA, Soares DR, Santos AMR, Araújo TME. Factors associated with the risk of diabetic foot in patients with diabetes mellitus in Primary Care. Rev Esc Enferm USP. 2021 Jul;55:e03757. https://doi.org/10.1590/S1980-220X2020019503757

Burihan MC, Campos Júnior W. SBACV-SP. Consenso no tratamento e prevenção do pé diabético. 1a ed. Rio de Janeiro: Guanabara Koogan; 2020.